Metabolism open最新文献

{"title":"Effect of short-term (4 weeks) low-calorie diet induced weight loss on beta-cell function in overweight normoglycemic subjects: A quasi-experimental pre-post interventional study","authors":"Monica Peter ,&nbsp;Mithra Balaji ,&nbsp;Joe Varghese ,&nbsp;Sam Marconi ,&nbsp;Yesudhas Sudhakar ,&nbsp;Felix Jebasingh ,&nbsp;Padmanaban Venkatesan","doi":"10.1016/j.metop.2025.100378","DOIUrl":"10.1016/j.metop.2025.100378","url":null,"abstract":"<div><h3>Introduction</h3><div>Diabetes in South Asians is driven primarily by impaired beta-cell function. When challenged with a high-calorie diet, this can result in metabolically unfavourable fat accumulation, which in turn worsens beta-cell function, thus constituting a vicious cycle. The investigators hypothesized that short-term mild-to-moderate weight loss induced by calorie restriction could break the cycle, resulting in significant improvements in beta-cell function. The objective of this study, therefore, was to evaluate the efficacy of a short-term weight loss program on body composition and beta-cell function.</div></div><div><h3>Methods</h3><div>As part of this quasi-experimental pre-post intervention study, 23 overweight normoglycemic participants underwent a low-calorie dietary intervention (∼1500 kcal/day) for a period of 4 weeks. Beta-cell function and insulin sensitivity were measured with a mixed meal challenge test (oral minimal model of glucose) before and after the intervention period. Changes in anthropometric parameters and body composition were also measured. The study was registered prospectively with the Clinical Trials Registry of India - CTRI/2023/04/051807 (<span><span>https://ctri.nic.in/</span><svg><path></path></svg></span>)</div></div><div><h3>Results</h3><div>Among the 23 participants in the study, 21 adhered to the intervention. The average weight loss was 3.5 % with an 11 % reduction in trunk fat mass. Beta-cell function, as measured by disposition index, increased by 128 % on average. Robust linear regression analysis showed that beta-cell function improved by 23 % for 1 % weight loss (P = 0.024).</div></div><div><h3>Conclusion</h3><div>A short-term mild-to-moderate weight loss in overweight normoglycemic subjects effectively improved their beta-cell function.</div></div>","PeriodicalId":94141,"journal":{"name":"Metabolism open","volume":"27 ","pages":"Article 100378"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144524206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interventional approaches to combat obesity: Exploring the metabolomic signature of weight loss trials","authors":"Eleni C. Pardali ,&nbsp;Christos Cholevas ,&nbsp;Odysseas Androutsos ,&nbsp;Christina Tsigalou ,&nbsp;Dimitrios Poulimeneas ,&nbsp;Dimitrios P. Bogdanos ,&nbsp;Maria Dalamaga ,&nbsp;Dimitrios G. Goulis ,&nbsp;Maria G. Grammatikopoulou","doi":"10.1016/j.metop.2025.100373","DOIUrl":"10.1016/j.metop.2025.100373","url":null,"abstract":"<div><div>Obesity is characterized by the expansion of adipose tissue, contributing to systemic low-grade inflammation, insulin resistance, and widespread disruption of metabolic pathways. These pathophysiological changes are strongly linked to the development of several chronic conditions, including metabolic syndrome, type 2 diabetes, cardiovascular disease, and certain forms of cancer. Metabolomics have emerged as a powerful analytical approach for elucidating obesity-related metabolic disturbances at both the cellular and systemic levels, enabling the identification of specific metabolic signatures associated with disease risk and progression.</div><div>This narrative review synthesizes findings from interventional weight loss studies that addressed obesity using various strategies, including dietary modification, physical activity, pharmacotherapy, and bariatric surgery. Focusing on studies employing metabolomic techniques, this review highlights both consistent and divergent patterns in metabolite changes observed following weight loss, particularly in the metabolism of amino acids, lipids, short-chain fatty acids, and other metabolic pathways affected by each intervention. These insights have the potential to inform the development of more personalized and effective therapeutic approaches for obesity, thereby advancing the implementation of precision medicine in obesity management.</div></div>","PeriodicalId":94141,"journal":{"name":"Metabolism open","volume":"27 ","pages":"Article 100373"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144489992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improved quality of life and glycemic management after switching from conventional rapid-acting insulin to ultra-rapid lispro in patients with diabetes","authors":"Yuriko Hajika,&nbsp;Yuji Kawaguchi","doi":"10.1016/j.metop.2025.100377","DOIUrl":"10.1016/j.metop.2025.100377","url":null,"abstract":"<div><div>For optimal postprandial glucose (PPG) management, rapid-acting insulin analogs (RAA) should be administered 15 min before a meal; however, this may not be possible for some individuals. Ultra-rapid lispro (URLi) can be administered 0–2 min before or &lt;20 min after a meal, which may improve patient satisfaction and PPG management. In this pilot study, we evaluated changes in quality of life (QOL) and glycemic management among Japanese outpatients with type 2 diabetes mellitus (T2DM) who switched from RAA to URLi. We enrolled 12 outpatients with T2DM and evaluated QOL using the insulin therapy-related (ITR) QOL questionnaire. The primary endpoint was the change in ITR-QOL scores at 12–15 weeks. Endpoints were evaluated using the one-sample Wilcoxon signed rank test or paired <em>t</em>-tests. URLi was associated with a significant increase in ITR-QOL (+15.1 ± 16.1 points, <em>p</em> &lt; 0.01), perception (+7.2 ± 6.9 points, <em>p</em> &lt; 0.01), and status (+7.9 ± 9.5 points, <em>p</em> &lt; 0.05) scores. At 12–15 weeks, the time in range significantly increased (+8.3 ± 9.2, <em>p</em> &lt; 0.05), time above range significantly decreased (−7.7 ± 10.2, <em>p</em> &lt; 0.05), and time below range showed no significant changes. Thus, switching from RAA to URLi significantly improved ITR-QOL questionnaire scores. In summary, URLi is an effective treatment alternative, providing flexible timing, improved glycemic management, and enhanced patient satisfaction.</div></div>","PeriodicalId":94141,"journal":{"name":"Metabolism open","volume":"27 ","pages":"Article 100377"},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144471445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Component-based approach of enhanced recovery after surgery protocols in bariatric surgery: A systematic review and meta-analysis of randomized controlled trials","authors":"Ibrahim Ezuddin M. Almaski ,&nbsp;Yazan Jumah Alalwani ,&nbsp;Reem Salem Alshammari ,&nbsp;Rayyan Mohammed A. Alassiri ,&nbsp;Salman Ahmed S. Jathmi ,&nbsp;Aishah Mohammed Alhadi ,&nbsp;Amal Saleh Alzahrani ,&nbsp;Mohammed Abdulwahed Alzahrani ,&nbsp;Ahmed Y. Azzam ,&nbsp;Tareq A. Maani","doi":"10.1016/j.metop.2025.100376","DOIUrl":"10.1016/j.metop.2025.100376","url":null,"abstract":"<div><h3>Introduction</h3><div>Enhanced recovery after surgery (ERAS) protocols are evidence-based care improvement processes designed to minimize and reduce the negative physiological consequences of surgery. While previous studies have investigated ERAS in bariatric surgery, none have evaluated which specific components contribute most significantly to improved outcomes.</div></div><div><h3>Methods</h3><div>We performed a systematic review and meta-analysis following PRISMA 2020 guidelines. Six randomized controlled trials (RCTs) with total of 740 patients comparing ERAS protocols to standard care in bariatric surgery were included. We conducted component-specific meta-regression analysis of 14 individual ERAS elements, dose-response analysis across three implementation levels (low: ≤4 components, medium: 5–8 components, high: ≥9 components), and component clustering to identify synergistic combinations. Meta-regression was used to determine the relative impact of individual components on recovery and safety outcomes.</div></div><div><h3>Results</h3><div>Six RCTs including a total of 740 patients were included. Patients randomized to ERAS protocols have experienced significant reductions in nausea and vomiting (OR: 0.42, 95 % CI: 0.19–0.95, P-value = 0.040), intraoperative time (MD: 5.40, 95 % CI: 3.05–7.77, P-value&lt;0.001), time to mobilization (MD: 3.78, 95 % CI: 5.46 to −2.10, P-value&lt;0.001), intensive care unit length of stay (MD: 0.70, 95 % CI: 0.13–1.27, P-value = 0.020), total hospital stay (MD: 0.42, 95 % CI: 0.69 to −0.16, P-value = 0.002), and functional hospital stay (MD: 0.60, 95 % CI: 0.98 to −0.22, P-value = 0.002). Component-based analysis demonstrated that early mobilization, anti-emetic protocols, optimized anesthesia, and multimodal analgesia contributed most significantly to improved outcomes. We observed a clear dose-response relationship, with greater benefits in studies implementing more ERAS components.</div></div><div><h3>Conclusion</h3><div>ERAS protocols significantly improve recovery metrics following bariatric surgery, with certain components demonstrating greater impact than others. Early mobilization and anti-emetic protocols appear particularly beneficial, while the “Complete Recovery Bundle” demonstrates synergistic effects. We recommend a tiered implementation approach, prioritizing high-impact components, especially in resource-limited settings.</div></div>","PeriodicalId":94141,"journal":{"name":"Metabolism open","volume":"27 ","pages":"Article 100376"},"PeriodicalIF":0.0,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144329716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of hepatic steatosis with increased plasma xanthine oxidoreductase activity: MedCity21 health examination registry","authors":"Masafumi Kurajoh ,&nbsp;Shinya Fukumoto ,&nbsp;Seigo Akari ,&nbsp;Takashi Nakamura ,&nbsp;Yuya Miki ,&nbsp;Yuki Nagata ,&nbsp;Tomoaki Morioka ,&nbsp;Katsuhito Mori ,&nbsp;Yasuo Imanishi ,&nbsp;Toshio Watanabe ,&nbsp;Masanori Emoto","doi":"10.1016/j.metop.2025.100374","DOIUrl":"10.1016/j.metop.2025.100374","url":null,"abstract":"<div><h3>Background</h3><div>Steatotic liver disease, characterized by hepatic steatosis, increases the risk of metabolic and cardiovascular diseases. We previously reported that the plasma activity of xanthine oxidoreductase (XOR), primarily expressed in the human liver, is also associated with these diseases. The present study examined whether hepatic steatosis is associated with increased XOR activity.</div></div><div><h3>Methods</h3><div>This cross-sectional study included 334 participants who underwent health examinations and were not receiving urate-lowering or insulin therapy. Values for controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) obtained with vibration-controlled transient elastography were used to assess hepatic steatosis and fibrosis. Plasma XOR activity was determined with our highly sensitive assay.</div></div><div><h3>Results</h3><div>Median CAP, LSM, and plasma XOR activity values were 234.0 dB/m, 3.6 kPa, and 27.2 pmol/h/mL, respectively. CAP was correlated with plasma XOR activity (ρ = 0.540, <em>P</em> &lt; 0.001) and subjects with hepatic steatosis (CAP ≥248 dB/m; n = 136) showed higher activity levels than those without (40.8 vs. 21.2 pmol/h/mL, <em>P</em> &lt; 0.001). Multivariable regression analyses, adjusted for confounding factors including aspartate aminotransferase, alanine aminotransferase, adiponectin, and homeostasis model assessment of insulin resistance (IR), indicated associations of CAP and hepatic steatosis with plasma XOR activity (β = 0.163, <em>P</em> &lt; 0.001; β = 0.086, <em>P</em> = 0.037, respectively). These associations remained consistent across subgroups stratified by alcohol consumption. Neither LSM nor hepatic fibrosis (LSM ≥7.9 kPa; n = 4) was associated with plasma XOR activity.</div></div><div><h3>Conclusions</h3><div>These results suggest that hepatic steatosis increases plasma XOR activity independent of liver enzymes, adiponectin, and IR.</div></div>","PeriodicalId":94141,"journal":{"name":"Metabolism open","volume":"27 ","pages":"Article 100374"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144279192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity: Prevalence, causes, consequences, management, preventive strategies and future research directions","authors":"Sirwan Khalid Ahmed,&nbsp;Ribwar Arsalan Mohammed","doi":"10.1016/j.metop.2025.100375","DOIUrl":"10.1016/j.metop.2025.100375","url":null,"abstract":"<div><div>Obesity has emerged as one of the most pressing global public health challenges of the 21st century. Obesity has reached epidemic proportions worldwide, with over 1 billion people classified as obese in 2022, representing 13 % of the global population. Since 1975, obesity rates have tripled, and projections indicate that by 2035, around 1.9 billion adults—approximately 25 % of the world's population—will be affected. Looking further ahead to 2050, it is estimated that 3.80 billion adults, representing more than half of the anticipated global adult population, will be living with overweight or obesity. The increasing burden of obesity is associated with an alarming rise in non-communicable diseases, including type 2 diabetes, cardiovascular diseases, and multiple cancers, collectively contributing to over 5 million deaths annually. Obesity is driven by complex interactions between genetic, behavioral, environmental, and socioeconomic factors, with rapid urbanization and globalization accelerating the consumption of high-calorie diets and sedentary lifestyles. While historically prevalent in high-income nations, obesity rates are now rising most rapidly in low- and middle-income countries (LMICs), with over 70 % of obese individuals living in developing nations. The economic costs of obesity are staggering, with projections estimating a global financial burden of $4.32 trillion per year by 2035, equivalent to 3 % of the global GDP. This article explores the epidemiology, determinants, health implications, and policy responses to obesity, emphasizing the urgent need for multisectoral strategies to mitigate its impact. Public health initiatives, taxation on sugar-sweetened beverages, improved food regulations, and increased physical activity promotion are essential components of evidence-based interventions. Addressing the obesity crisis requires global cooperation to implement sustainable, long-term strategies targeting both prevention and treatment.</div></div>","PeriodicalId":94141,"journal":{"name":"Metabolism open","volume":"27 ","pages":"Article 100375"},"PeriodicalIF":0.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144279193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PCSK9-promoted LDLR degradation: Recruitment or prevention of essential cofactors?","authors":"Rong Li ,&nbsp;Cindy Xinyi Zhang ,&nbsp;Junli Liu ,&nbsp;Da-wei Zhang","doi":"10.1016/j.metop.2025.100362","DOIUrl":"10.1016/j.metop.2025.100362","url":null,"abstract":"","PeriodicalId":94141,"journal":{"name":"Metabolism open","volume":"26 ","pages":"Article 100362"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144272116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of DNA glycation in the prediabetic State: Early indicator of glycemic stress","authors":"Tanish Baweja ,&nbsp;Abhishek Dikshit ,&nbsp;Shazia Bano ,&nbsp;Sanjiv Kumar Bansal ,&nbsp;Sana Alam","doi":"10.1016/j.metop.2025.100372","DOIUrl":"10.1016/j.metop.2025.100372","url":null,"abstract":"<div><h3>Introduction</h3><div>Glycation of nucleic acids secondary to hyperglycemia can lead to structural alterations and the formation of neoantigens. These molecular changes may elicit an early immune response. This study investigates the interaction between serum autoantibodies from prediabetic individuals and fructose-glycated human placental DNA, aiming to assess DNA glycation as a potential early indicator of glycemic stress.</div></div><div><h3>Design</h3><div>and Methods: To investigate structural modifications in DNA produced by glycation, purified placental DNA was incubated with fructose (25 mM) at 37 °C for 5, 10, and 15 days, followed by spectrophotometric analysis. Peripheral blood samples were collected from 50 normoglycemic (mean age: 39.70 ± 6.63 years; 26 males, 24 females) and 50 prediabetic (mean age: 40.84 ± 5.44 years; 23 males, 27 females) adult patients, matched for age, sex, body mass index, and socio-economic conditions. The presence of circulating antibodies against glycated DNA was evaluated using direct and competitive ELISA.</div></div><div><h3>Results</h3><div>Fructose-mediated glycation of DNA resulted in hyperchromicity and a new absorbance peak at 360 nm, indicating structural modification. Direct ELISA revealed significantly higher levels of anti-DNA autoantibodies in prediabetic sera (0.367 ± 0.225) compared to controls (0.239 ± 0.118; p = 0.003). Competitive ELISA showed that these antibodies had greater specificity for glycated DNA, with maximum inhibition by fructose-modified DNA at 37.86 ± 2.57 %, versus 23.01 ± 2.33 % for native DNA (p &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>The study concludes that DNA glycation occurs in prediabetic patients with intermediate hyperglycemia as a result of high blood glucose. This suggests that glycated DNA may serve as an early molecular indicator of glycemic stress, with potential applications in risk assessment and early detection strategies for individuals at risk of progressing to type 2 diabetes.</div></div>","PeriodicalId":94141,"journal":{"name":"Metabolism open","volume":"26 ","pages":"Article 100372"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144229659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Higher serum uric acid levels and risk of all-cause mortality in general population: a systematic review and meta-analysis","authors":"Md Golam Rabbani ,&nbsp;Sheikh M. Alif ,&nbsp;Cammie Tran ,&nbsp;Amanda J. Rickard ,&nbsp;Lisa Demos ,&nbsp;John J. McNeil ,&nbsp;Md Nazmul Karim","doi":"10.1016/j.metop.2025.100371","DOIUrl":"10.1016/j.metop.2025.100371","url":null,"abstract":"<div><h3>Background</h3><div>Population-based studies have reported a relationship between high serum uric acid (SUA) levels and all-cause mortality; however, findings are inconsistent. To address this issue, we conducted a meta-analysis of general population-based studies.</div></div><div><h3>Methods</h3><div>A systematic search was conducted in PubMed, Ovid Medline, EMBASE, and Web of science to identify relevant peer-reviewed articles using pre-specified search terms. Population-based cohort studies investigating the association between SUA levels and all-cause mortality were included. Risk ratios (RR) for all-cause mortality were calculated for higher and lower SUA levels based on data reporting on exposure and outcome. A meta-analysis based on a log-transformed random effect maximum likelihood model was used to obtain summary risk estimates. Heterogeneity was assessed through subgroup analysis and meta-regression of the study-level covariates.</div></div><div><h3>Results</h3><div>Thirty-four studies with more than 2.5 million participants were identified and analysed. Higher SUA levels were associated with an increased risk of all-cause mortality (RR: 1.32; 95 % confidence intervals (CIs):1.26–1.39, p &lt; 0.001). The risk of mortality was higher in women (RR:1.91; 95 %CI:1.40–2.61, p &lt; 0.001) compared to men (RR:1.16; 95 %CI:1.08 1.24, p &lt; 0.001). Subgroup analyses suggested that middle-aged adults (RR: 1.52, 95 %CI: 1.35–1.68), individuals living in OECD countries (RR:1.39, 95 %CI:1.28–1.49) and those of Caucasian ethnicity (RR:1.43, 95 %CI:1.35–1.51) reported a greater impact of elevated SUA levels on all-cause mortality.</div></div><div><h3>Conclusions</h3><div>Higher SUA levels were associated with a significant increase in the risk of all-cause mortality, with women appearing to be at greater risk than men. These findings highlight the need for research into mechanisms underlying the association between SUA and mortality and the reason for the sex difference identified.</div></div>","PeriodicalId":94141,"journal":{"name":"Metabolism open","volume":"26 ","pages":"Article 100371"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144084029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recovery time of diabetic ketoacidosis in Africa: Systematic review and meta-analysis","authors":"Tadios Lidetu ,&nbsp;Simon Birhanu ,&nbsp;Addisu Simachew Asgai ,&nbsp;Tsegaamlak Kumelachew Derse ,&nbsp;Yideg Abinew ,&nbsp;Moges Tadesse ,&nbsp;Desalegn Mitiku ,&nbsp;Jemberu Chane ,&nbsp;Banchamilak Adane ,&nbsp;Tadele Kassahun Wudu ,&nbsp;Betelhem Mekonnen ,&nbsp;Desiyalew Habtamu Tamiru","doi":"10.1016/j.metop.2025.100370","DOIUrl":"10.1016/j.metop.2025.100370","url":null,"abstract":"<div><h3>Background</h3><div>Diabetes mellitus is a long-term metabolic disease marked by consistently elevated blood glucose levels. Diabetic ketoacidosis is the medical consequence of diabetes mellitus that has the highest attributed fatality rate. Socioeconomically differences affect how long it takes to recover from diabetic ketoacidosis. A few research were carried out in Africa to demonstrate how long diabetic ketoacidosis takes to recover. However, the pooled median recovery time and predictors of diabetic ketoacidosis have not been studied in Africa. Thus, determine the pooled median recovery time and predictors of diabetic ketoacidosis in Africa was the aim of this systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>To find available publications, a number of databases were analyzed, including PubMed, Science Direct, Cochrane, Hinari, Google Scholar, grey literature, and articles from various university repository sites. Microsoft Excel version 13 was used to extract and sort the data before exporting it to STATA/MP 17.0 for analysis. The quality of each study was evaluated using the Newcastle-Ottawa Scale. A 95 percent confidence interval Der Simonian random-effects model was employed to investigate the pooled recovery time of diabetic ketoacidosis. Publication bias and heterogeneity were assessed using the Egger's test and I². Both meta-regression and subgroup analysis were used to determine the potential source of heterogeneity. Statistical significance was defined as P-values below 0.05.</div></div><div><h3>Result</h3><div>The pooled median recovery time for diabetic ketoacidosis in Africa was 38 h (95 percent CI: 33–43 h), according to this comprehensive review and meta-analysis. Significant heterogeneity is evident when looking at the Galbraith plot with I2 = 100 % (p &lt; 0.001). Research conducted after 2020 revealed that diabetic ketoacidosis has a long recovery time of 40 h (95 percent CI: 3–77 h). However, research with fewer than 300 participants showed that diabetic ketoacidosis recovered more quickly: 18 h (95 percent confidence interval: 12–24 h).</div></div><div><h3>Conclusion</h3><div>Among patients with diabetic ketoacidosis in Africa, the pooled median recovery time was lengthy. The recovery time from diabetic ketoacidosis was influenced by a number of factors, including the severity of the diabetic ketoacidosis, the delay in starting therapy, and the length of time the patient had diabetes mellitus, and elevated blood glucose levels. Diabetic ketoacidosis recovery time can be shortened by altering these factors.</div></div>","PeriodicalId":94141,"journal":{"name":"Metabolism open","volume":"26 ","pages":"Article 100370"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}